Open AccessRole of transaminases, CRP and LDH in COVID-19 patients with and without respiratory failure during the disease outbreak
Author(s) -
Bianca Magro,
Matteo Tacelli,
L. Pasulo,
Massimo De Giorgio,
Francesca Leonardi,
L Grazia,
G. Gaffuri,
Michela Triolo,
G. Mangia,
Domenico Nobile,
Marco Rizzi,
Fabiano Di Marco,
Roberto Cosentini,
Andrea Gianatti,
S. Fagiuoli
Publication year - 2021
Publication title -
medical research archives
Language(s) - English
Resource type - Journals
eISSN - 2375-1924
pISSN - 2375-1916
DOI - 10.18103/mra.v9i12.2593
Subject(s) - medicine , clinical endpoint , gastroenterology , liver disease , pneumonia , multivariate analysis , alanine transaminase , disease , mechanical ventilation , randomized controlled trial
BACKGROUND: Sars-Cov-2 pneumonia is a pandemic disease with high morbidity and mortality. In literature transaminases, CRP and LDH were frequently found abnormal but their role has not been clarified. OBJECTIVES: Aim of this retrospective study is to explore the role of transaminases, CRP and LDH on short-term prognosis of hospitalized COVID-19 patients. METHODS: patients admitted in hospital for COVID-19 were consecutively recruited. Primary endpoint: evaluate role of transaminases, CRP and LDH on disease progression (DP). Secondary endpoints: find possible risk factors for (1) mortality and (2) CPAP ventilation at day 7. We also analyzed patients without respiratory failure at admission, also a subgroup of patients with liver disease. RESULTS: 342 patients were included. Median age of patients was 64 years (IQR 55-74), and 35.1% (n=120) was female. At multivariate analysis moderate ALT elevation at Day 1 (p=0.001, OR 2,42, CI95% 1.23-4,73) and CRP at Day 7 (p=0.001, OR 1, CI95% 1-1,1) were predictors of DP; LDH at admission (p=0.05, OR 1, CI95% 1.23-1,1) and moderate AST elevation at day 7 (p=0.04, OR 4,5, CI95% 1.05-19,4) were predictors of CPAP at day 7. At multivariate analysis age (p<0,001, OR 1,12, CI95% 1-1,2) and sex (p=0.01, OR 14, CI95% 1,7-116,7) were predictors of death. Mortality rate of patients with liver disease was 25%(n=3/12). CONCLUSIONS: Moderate ALT elevation at day 1 and moderate AST elevation at day 7 were respectively, predictors of DP and CPAP at day 7. For patients without respiratory failure, transaminases are not significative for anyone of our outcomes. Age, sex and CRP at day 1 are death risk factors.