Increased Morbidity and Mortality in COVID-19 Patients with Liver Injury

Authors

Mohammad A. Siddiqui, Henry Ford HealthFollow
Suraj Suresh, Henry Ford HealthFollow
Stephen Simmer, Henry Ford HealthFollow
Mouhanna Abu Ghanimeh, Henry Ford HealthFollow
Megan Karrick, Henry Ford HealthFollow
Faisal M. Nimri, Henry Ford HealthFollow
Maher Musleh, Henry Ford HealthFollow
Vivek Mendiratta, Henry Ford HealthFollow
Mustafa Al-Shammari, Henry Ford HealthFollow
Sarah Russell, Henry Ford HealthFollow
Jessica Jou, Henry Ford HealthFollow
Duyen Dang, Henry Ford HealthFollow
Reena Salgia, Henry Ford HealthFollow
Tobias Zuchelli, Henry Ford HealthFollow

Recommended Citation

Siddiqui MA, Suresh S, Simmer S, Abu-Ghanimeh M, Karrick M, Nimri F, Musleh M, Mediratta V, Al-Shammari M, Russell S, Jou J, Dang D, Salgia R, and Zuchelli T. Increased Morbidity and Mortality in COVID-19 Patients with Liver Injury. Dig Dis Sci 2021;1-7.

Document Type

Article

Publication Date

5-4-2021

Publication Title

Digestive diseases and sciences

Abstract

BACKGROUND: There is a high prevalence of liver injury (LI) in patients with coronavirus disease 2019 (COVID-19); however, few large-scale studies assessing risk factors and clinical outcomes in these patients have been done.

AIMS: To evaluate the risk factors and clinical outcomes associated with LI in a large inpatient cohort of COVID-19 patients.

METHODS: Adult patients with COVID-19 between March 1 and April 30, 2020, were included. LI was defined as peak levels of alanine aminotransferase/aspartate aminotransferase that were 3 times the ULN or peak levels in alkaline phosphatase/total bilirubin that were 2 times the ULN. Mild elevation in liver enzymes (MEL) was defined as abnormal peak liver enzyme levels lower than the threshold for LI. Patients with MEL and LI were compared to a control group comprising patients with normal liver enzymes throughout hospitalization.

RESULTS: Of 1935 hospitalized COVID-19 patients, 1031 (53.2%) had MEL and 396 (20.5%) had LI. Compared to control patients, MEL and LI groups contained proportionately more men. Patients in the MEL cohort were older compared to control, and African-Americans were more highly represented in the LI group. Patients with LI had an increased risk of mortality (relative risk [RR] 4.26), intensive care unit admission (RR, 5.52), intubation (RR, 11.01), 30-day readmission (RR, 1.81), length of hospitalization, and intensive care unit stay (10.49 and 10.06 days, respectively) compared to control.

CONCLUSION: Our study showed that patients with COVID-19 who presented with LI had a significantly increased risk of mortality and poor clinical outcomes.

PubMed ID

33945064

ePublication

ePub ahead of print