Hepatotoxicity and Its Impact on Mortality in COVID-19 Patients
Hepatotoxicty in COVID-19
DOI:
https://doi.org/10.37609/srinmed.1Keywords:
COVID-19, liver function tests, mortality, alanine aminotransferase, aspartate aminotransferaseAbstract
Objective: "COVID-19-related liver damage" can occur frequently in course of COVID-19 disease and cause significant problems. Our study aimed to investigate prevalence of liver damage due to COVID-19, its risk variables, and the effect of liver damage on course of COVID-19 and mortality.
Method: One hundred patients over eighteen years of age who were hospitalized between 01.08.2021-01.03.2022 and had positive RT-PCR tests were included in our study. Impaired liver function tests were identified as having alanine aminotransferase(ALT) and aspartate aminotransferase(AST) levels exceeding upper laboratory limits.
Results: The mean age of patients included in study was 57.9 ± 14.9 years, with 49% of them being male. In our study, we had an 8% death rate and 37% of patients had abnormal liver function tests. The presence of severe disease(p<0.001), anorexia symptoms(p=0.027), and abdominal pain(p=0.010) were significant for mortality. A prolonged hospital stay was significantly associated with death(p=0.029), with the mean length of hospital stay being 11.8 ± 4.6 days. Favipiravir use for longer than five days was associated with a substantial risk of liver damage(p=0.044) and mortality(p=0.020), while use of antibiotics in carbapenem group was associated with a significant risk of death(p=0.001).
Conclusions: It is noteworthy that a considerable proportion of COVID-19 patients may exhibit increased liver tests, which could serve as a significant predictor and risk factor, particularly with regard to mortality. In order to properly monitor and manage COVID-19 patients, particularly those who are at risk, comprehensive measurements, including liver tests, should be carried out on a regular basis.
References
World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic. Accessed on March 6, 2023. https://www.who.int/emergencies/diseases/novel-coronavirus-2019?adgroupsurvey
Cascella M, Rajnik M, Aleem A, et al. Features, Evaluation, and Treatment of Coronavirus (COVID-19). 2023 Jan 9. In: StatPearls [Internet].
Sun J, Aghemo A, Forner A, Valenti L. COVID-19 and liver disease. Liver Int. 2020 Jun; 40(6): 1278-1281.
Metawea MI, Yousif WI, Moheb I. COVID 19 and liver: An A-Z literature review. Dig Liver Dis. 2021 Feb; 53(2): 146-152.
Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA - J Am Med Assoc 2020; 323: 2052–9.
Cai Q, Huang D, Yu H, et al. COVID-19: abnormal liver function tests. J Hepatol 2020 Sep; 73(3): 566-574.
Kukla M, Skonieczna- Z˙ ydecka K, Kotfis K, et al. COVID-19, MERS and SARS with concomitant liver injury-systematic review of the existing literature. J Clin Med 2020; 9: 1420.
Kulkarni AV, Kumar P, Tevethia HV, et al. Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19. Aliment Pharmacol Ther 2020; 52: 584–99.
Wang Q, Wang Q, Zhao H, et al. Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients. Mil Med Res 2020; 7:28.
Grein J, Ohmagari N, Shin D, et al. Compassionate use of Remdesivir for patients with severe Covid-19. N Engl J Med 2020;382:2327–36.
Parohan M, Yaghoubi S, Seraj A. Liver injury is associated with severe Coronavirus disease 2019 (COVID-19) infection: a systematic review and metaanalysis of retrospective studies. Hepatol Res 2020;10.
Xie H, Zhao J, Lian N, et al. Clinical characteristics of non-ICU hospitalized patients with coronavirus disease 2019 and liver injury: a retrospective study. Liver Int 2020;40:321–6.
Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA – J Am Med Assoc 2020;323:1061–9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Scientific Reports in Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Notice
Scientific Reports in Medicine is an open access scientific journal. Open access means that all content is freely available without charge to the user or his/her institution on the principle that making research freely available to the public supports a greater global exchange of knowledge. The Journal and content of this website is licensed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access.
The Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allows users to copy, distribute and transmit an article, adapt the article and make noncommercial use of the article. The CC BY-NC-ND license permits non-commercial re-use of an open access article, as long as the author is properly attributed.
Scientific Reports in Medicine requires the author as the rights holder to sign and submit the journal's agreement form prior to acceptance. The authors transfer all financial rights, especially processing, reproduction, representation, printing, distribution, and online transmittal to Academician Publishing with no limitation whatsoever, and grant Academician Publishing for its publication. This ensures both that The Journal has the right to publish the article and that the author has confirmed various things including that it is their original work and that it is based on valid research.
Authors who publish with this journal agree to the following terms:
*Authors transfer copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
*Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
*Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Self Archiving Policy
*The Journal allows authors to self-archive their articles in an open access repository. The Journal considers publishing material where a pre-print or working paper has been previously mounted online. The Journal does not consider this an exception to our policy regarding the originality of the paper (not to be published elsewhere), since the open access repository doesn't have a publisher character, but an archiving system for the benefit of the public.
The Journal's policy regarding the accepted articles requires authors not to mention, in the archived articles in an open access repository, their acceptance for publication in the journal until the article is final and no modifications can be made. Authors are not allowed to submit the paper to another publisher while is still being evaluated for the Journal or is in the process of revision after the peer review decision.
The Journal does allow the authors to archive the final published article, often a pdf file, in an open access repository, after authors inform the editorial office. The final version of the article and its internet page contains information about copyright and how to cite the article. Only this final version of the article is uploaded online, on the Journal's official website, and only this version should be used for self-archiving and should replace the previous versions uploaded by authors in the open access repository.