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Longitudinal Association Between Markers of Liver Injury and Mortality in COVID‐19 in China
Author(s) -
Lei Fang,
Liu YeMao,
Zhou Feng,
Qin JuanJuan,
Zhang Peng,
Zhu Lihua,
Zhang XiaoJing,
Cai Jingjing,
Lin Lijin,
Ouyang Shan,
Wang Xiaoming,
Yang Chengzhang,
Cheng Xu,
Liu Weifang,
Li Haomiao,
Xie Jing,
Wu Bin,
Luo Huiming,
Xiao Fei,
Chen Jing,
Tao Liang,
Cheng Gang,
She ZhiGang,
Zhou Jianghua,
Wang Haitao,
Lin Jun,
Luo Pengcheng,
Fu Shouzhi,
Zhou Jihui,
Ye Ping,
Xiao Bing,
Mao Weiming,
Liu Liming,
Yan Youqin,
Liu Ling,
Chen Guohua,
Li Hongliang,
Huang Xiaodong,
Zhang BingHong,
Yuan Yufeng
Publication year - 2020
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.31301
Subject(s) - medicine , liver injury , bilirubin , alanine transaminase , retrospective cohort study , gastroenterology , liver function , liver disease , liver function tests
Background and Aims Coronavirus disease 2019 (COVID‐19) is a new infectious disease. To reveal the hepatic injury related to this disease and its clinical significance, we conducted a multicenter retrospective cohort study that included 5,771 adult patients with COVID‐19 pneumonia in Hubei Province. Approach and Results We reported the distributional and temporal patterns of liver injury indicators in these patients and determined their associated factors and death risk. Longitudinal liver function tests were retrospectively analyzed and correlated with the risk factors and death. Liver injury dynamic patterns differed in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL). AST elevated first, followed by ALT, in severe patients. ALP modestly increased during hospitalization and largely remained in the normal range. The fluctuation in TBIL levels was mild in the non‐severe and the severe groups. AST abnormality was associated with the highest mortality risk compared with the other indicators of liver injury during hospitalization. Common factors associated with elevated liver injury indicators were lymphocyte count decrease, neutrophil count increase, and male gender. Conclusion The dynamic patterns of liver injury indicators and their potential risk factors may provide an important explanation for the COVID‐19‐associated liver injury. Because elevated liver injury indicators, particularly AST, are strongly associated with the mortality risk, our study indicates that these parameters should be monitored during hospitalization.