Open AccessLiver stiffness is associated with disease severity and worse clinical scenarios in coronavirus disease 2019: A prospective transient elastography study
Author(s) -
Demirtas Coskun Ozer,
Keklikkiran Caglayan,
Ergenc Ilkay,
Erturk Sengel Buket,
Eskidemir Gunes,
Cinel Ismail,
Odabasi Zekaver,
Korten Volkan,
Yilmaz Yusuf
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.14363
Subject(s) - medicine , transient elastography , severity of illness , prospective cohort study , odds ratio , gastroenterology , liver disease , confidence interval , fibrosis , intensive care unit , disease , liver fibrosis
Background Pre‐existing chronic liver disease is currently considered a poor prognostic factor for coronavirus disease 2019 (COVID‐19). The present study aimed to investigate the association of liver stiffness measurement (LSM) with disease severity and clinical course of COVID‐19. Methods We prospectively recruited consecutive hospitalised adult patients with COVID‐19 in a 3‐month period. Demographic, laboratory, clinical and vibration‐controlled transient elastography (VCTE) features were recorded at entry, and all patients were prospectively followed‐up. Severe liver fibrosis was defined as an LSM value higher than 9.6 kPA. Multivariate logistic regression analysis was performed to reveal factors associated with disease severity and outcomes. Results Out of 98 eligible patients with COVID‐19, 12 (12.2%) had severe liver fibrosis. Patients with severe liver fibrosis had higher baseline disease severity ( P = .022), more commonly required oxygen treatment at entry ( P = .010), and had intensive‐care unit (ICU) requirements during the 6 (1‐39)‐day median follow‐up time ( P = .017). The presence of severe liver fibrosis was independently associated with disease severity (odds ratio (OR): 7.685, 95% confidence interval (CI): 1.435‐41.162, P = .017) and ICU requirement (OR: 46.656, 95% CI: 2.144‐1015.090, P = .014). LSM was correlated with alanine aminotransferase levels ( P = .005, r: 0.283), but not with other markers of acute hepatic injury or inflammation. Conclusion Initial VCTE application might help physicians identify patients who are more likely to have severe illness or worse clinical outcomes, in addition to other well‐established clinical and laboratory factors. Further multicentre prospective studies are warranted to validate our results.