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Liver damage at admission is an independent prognostic factor for COVID ‐19
Author(s) -
Chen Liu Ying,
Chu Hui Kuan,
Bai Tao,
Tu Sheng Jin,
Wei Yuan,
Li Zhong Lin,
Hu Li Lin,
Zhu Rui,
Zhang Lei,
Han Chao Qun,
Xiao Li,
He Qi,
Song Jun,
Liu Wei Hua,
Zhu Qing Jing,
Chen Hua,
Yang Ling,
Hou Xiao Hua
Publication year - 2020
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12925
Subject(s) - medicine , gastroenterology , hazard ratio , proportional hazards model , liver function , liver function tests , creatinine , confidence interval , lactate dehydrogenase , liver injury , procalcitonin , sepsis , biochemistry , chemistry , enzyme
Objective Abnormal liver function is a common form of extra‐pulmonary organ damage in patients with coronavirus disease 2019 (COVID‐19). Patients with severe COVID‐19 have a higher probability and progression of liver injury than those without severe disease. We aimed to evaluate the prognosis of liver injury in patients with COVID‐19. Methods We retrospectively included 502 patients with laboratory‐confirmed SARS‐CoV‐2 infection. Clinical features and survival of patients with and without liver injury were compared. Cox proportional hazards models were used to determine the variables that might have an effect on survival. Results Among the 502 patients enrolled, 301 patients had abnormal liver function with increased neutrophil count, C‐reactive protein, creatinine, troponin I (TnI), D‐dimer, lactose dehydrogenase and creatine kinase. Patients with abnormal liver functions had a higher mortality rate (28.9% vs 9.0%, P < 0.001), a higher ratio of male sex (65.1% vs 40.8%, P < 0.001) and a higher chance of developing systemic inflammatory response syndrome (53.5% vs 41.3%, P = 0.007). Among patients with abnormal liver functions, patients with grade 2 liver damage (with both abnormal alanine aminotransferase or aspartate aminotransferase levels and abnormal alkaline phosphatase or gamma‐glutamyl transpeptidase levels) had a higher ratio of male patients, elevated neutrophil count, procalcitonin, D‐dimer levels and mortality rate. Multivariate Cox regression analyses suggested that the grade of liver damage (hazard ratio: 1.377, 95% confidence interval: 1.000‐1.896, P = 0.049) was an independent predictor of death. Conclusions Patients with COVID‐19 and abnormal liver functions have a higher mortality than those with normal liver functions. Liver damage is an independent prognostic factor of COVID‐19.