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Observational Study
. 2020 Nov;15(8):1399-1407.
doi: 10.1007/s11739-020-02425-w. Epub 2020 Jul 10.

Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

Marco Vincenzo Lenti #  1 , Federica Borrelli de Andreis #  1 , Ivan Pellegrino  1 , Catherine Klersy  2 , Stefania Merli  1 , Emanuela Miceli  1 , Nicola Aronico  1 , Caterina Mengoli  1 , Michele Di Stefano  1 , Sara Cococcia  1 , Giovanni Santacroce  1 , Simone Soriano  1 , Federica Melazzini  1 , Mariangela Delliponti  1 , Fausto Baldanti  3 , Antonio Triarico  4 , Gino Roberto Corazza  1 , Massimo Pinzani  5 , Antonio Di Sabatino  6   7 ; Internal Medicine Covid-19 Team
Collaborators, Affiliations
Observational Study

Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

Marco Vincenzo Lenti et al. Intern Emerg Med. 2020 Nov.

Abstract

Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25-97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07-5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.

Keywords: Acute respiratory failure; Coronavirus; Hepatitis; Severe acute respiratory syndrome.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Comparison of medians of blood tests indicative of abnormal liver function at hospital admission (baseline) and at last follow-up. Wilcoxon test was performed to evaluate statistical significance. ALT, alanine aminotransferase; ALP, alkaline phosphatase; AST, aspartate aminotransferase; CRP, C reactive protein; GGT, gamma-glutamyl transpeptidase; INR, international normalised ratio; LDH, lactate dehydrogenase
See this image and copyright information in PMC

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