<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background and aims.</bold> Patients with COVID-19 frequently present abnormal elevated liver function tests of unknown clinical significance. We aimed to investigate the characteristics and factors influencing outcome in patients with confirmed SARS-CoV-2 infection and liver injury on admission.<bold>Methods.</bold> This is a retrospective observational study of patients hospitalized in two COVID units in Romania. Relevant data on clinical and laboratory parameters and medication administered during the admission were analyzed to identify predictors of a negative outcome. Patients with confirmed COVID-19 and liver function tests (LFTs) above the upper limit of normal were included in the analysis.<bold>Results.</bold> From 1,207 patients, we identified 134 patients (11%) with abnormal LFTs during hospitalization. The majority of patients had mildly elevated levels and a predominantly cholestatic pattern of liver injury. Patients who received lopinavir/ritonavir were more likely to have increased ALAT levels (<italic>p</italic>&lt;0.0001). Sixteen patients had pre-existing chronic liver disease, and they were more likely to suffer from severe COVID-19 (p=0.009) and have a negative outcome (p&lt;0.001), but on multivariate analysis, only the severity of COVID-19 was predictive of death (OR 69.9; 95% CI 6.4-761.4).<bold>Conclusions.</bold> Mild liver injury is relatively common in COVID-19 and possibly influenced by medication. Patients with chronic liver disease are at high risk for negative outcome, but the severity of the infection is the only predictor of death.</abstract>

Background and aims. Patients with COVID-19 frequently present abnormal elevated liver function tests of unknown clinical significance. We aimed to investigate the characteristics and factors influencing outcome in patients with confirmed SARS-CoV-2 infection and liver injury on admission.Methods. This is a retrospective observational study of patients hospitalized in two COVID units in Romania. Relevant data on clinical and laboratory parameters and medication administered during the admission were analyzed to identify predictors of a negative outcome. Patients with confirmed COVID-19 and liver function tests (LFTs) above the upper limit of normal were included in the analysis.Results. From 1,207 patients, we identified 134 patients (11%) with abnormal LFTs during hospitalization. The majority of patients had mildly elevated levels and a predominantly cholestatic pattern of liver injury. Patients who received lopinavir/ritonavir were more likely to have increased ALAT levels (p<0.0001). Sixteen patients had pre-existing chronic liver disease, and they were more likely to suffer from severe COVID-19 (p=0.009) and have a negative outcome (p<0.001), but on multivariate analysis, only the severity of COVID-19 was predictive of death (OR 69.9; 95% CI 6.4-761.4).Conclusions. Mild liver injury is relatively common in COVID-19 and possibly influenced by medication. Patients with chronic liver disease are at high risk for negative outcome, but the severity of the infection is the only predictor of death.

Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience

Carol Davila University of Medicine and Pharmacy

University of Medicine, Pharmacy Sciences and Technology “George Emil Palade” Târgu Mureș

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background and aims. Patients with COVID-19 frequently present abnormal elevated liver function tests of unknown clinical significance. We aimed to investigate...

Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience

Publicado en línea: 17 mar 2022

Páginas: 49 - 55

Recibido: 24 may 2021

DOI: https://doi.org/10.2478/rjim-2021-0027

Palabras clave
COVID-19, liver injury, SARS-CoV-2, drug-induced liver injury, hepatitis, hydroxychloroquine, lopinavir/ritonavir, antiviral therapy

© 2022 Andrei Voiosu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience

Publicado en línea: 17 mar 2022

Páginas: 49 - 55

Recibido: 24 may 2021

DOI: https://doi.org/10.2478/rjim-2021-0027

Palabras claveCOVID-19, liver injury, SARS-CoV-2, drug-induced liver injury, hepatitis, hydroxychloroquine, lopinavir/ritonavir, antiviral therapy

© 2022 Andrei Voiosu et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Palabras clave
COVID-19, liver injury, SARS-CoV-2, drug-induced liver injury, hepatitis, hydroxychloroquine, lopinavir/ritonavir, antiviral therapy