Liver injury in hospitalized patients with COVID-19: An International observational cohort study
- Autori: Tirupakuzhi Vijayaraghavan, Bharath Kumar; Bishnu, Saptarshi; Baruch, Joaquin; Citarella, Barbara Wanjiru; Kartsonaki, Christiana; Meeyai, Aronrag; Mohamed, Zubair; Ohshimo, Shinichiro; Lefèvre, Benjamin; Al-Fares, Abdulrahman; Calvache, Jose A.; Taccone, Fabio Silvio; Olliaro, Piero; Merson, Laura; Adhikari, Neill K.J.;Sheryl Ann Abdukahil, Nurul Najmee Abdulkadir, Ryuzo Abe, Laurent Abel, Amal Abrous, Lara Absil, Andrew Acker, Elisabeth Adam, Diana Adrião, Saleh Al Ageel, Kate Ainscough, Ali Ait Hssain, Younes Ait Tamlihat, Takako Akimoto, Ernita Akmal, Eman Al Qasim, Angela Alberti, Tala Al-dabbous, Senthilkumar Alegesan, Marta Alessi, Beatrice Alex, Kévin Alexandre, Abdulrahman Al-Fares, Huda Alfoudri, Imran Ali, Kazali Enagnon Alidjnou, Jeffrey Aliudin, Clotilde Allavena, Nathalie Allou, João Melo Alves, Rita Alves, Joana Alves Cabrita, Maria Amaral, Nur Amira, Phoebe Ampaw, Claire Andrejak, Andrea Angheben, François Angoulvant, Séverine Ansart, Sivanesen Anthonidass, Carlos Alexandre Antunes de Brito, Ardiyan Apriyana, Yaseen Arabi, Irene Aragao, Francisco Arancibia, Carolline Araujo, Antonio Arcadipane, Patrick Archambault, Lukas Arenz, Jean-Benoît Arlet, Christel Arnold-Day, Lovkesh Arora, Rakesh Arora, Elise Artaud-Macari, Diptesh Aryal, Muhammad Ashraf, Namra Asif, Jean Baptiste Assie, Amirul Asyraf, Minahel Atif, Anika Atique, Johann Auchabie, Hugues Aumaitre, Adrien Auvet, Laurène Azemar, Cecile Azoulay, Benjamin Bach, Delphine Bachelet, Claudine Badr, Nadia Baig, J. Kenneth Baillie, Erica Bak, Nazreen Abu Bakar, Andriy Bal, Mohanaprasanth Balakrishnan, Valeria Balan, Firouzé Bani-Sadr, Renata Barbalho, Nicholas Yuri Barbosa, Wendy S. Barclay, Saef Umar Barnett, Michaela Barnikel, Audrey Barrelet, Cleide Barrigoto, Marie Bartoli, JoaquÃn Baruch, Romain Basmaci, Muhammad Fadhli Hassin Basri, Jules Bauer, Diego Fernando Bautista Rincon, Abigail Beane, Alexandra Bedossa, Ker Hong Bee, Husna Begum, Sylvie Behilill, Albertus Beishuizen, Aleksandr Beljantsev, David Bellemare, Anna Beltrame, Beatriz Amorim Beltrão, Marine Beluze, Nicolas Benech, Lionel Eric Benjiman, Dehbia Benkerrou, Suzanne Bennett, LuÃs Bento, Jan-Erik Berdal, Delphine Bergeaud, Hazel Bergin, Giulia Bertoli, Simon Bessis, Sybille Bevilcaqua, Karine Bezulier, Amar Bhatt, Krishna Bhavsar, Claudia Bianco, Farah Nadiah Bidin, Moirangthem Bikram Singh, Felwa Bin Humaid, Mohd Nazlin Bin Kamarudin, François Bissuel, Patrick Biston, Laurent Bitker, Catherine Blier, Mathieu Blot, Lucille Blumberg, Laetitia Bodenes, Debby Bogaert, Anne-Hélène Boivin, Isabela Bolaños, Pierre-Adrien Bolze, François Bompart, Diogo Borges, Raphaël Borie, Elisabeth Botelho-Nevers, Lila Bouadma, Olivier Bouchaud, Sabelline Bouchez, Dounia Bouhmani, Damien Bouhour, Kévin Bouiller, Laurence Bouillet, Camile Bouisse, Anne-Sophie Boureau, John Bourke, Maude Bouscambert, Aurore Bousquet, Jason Bouziotis, Bianca Boxma, Marielle Boyer-Besseyre, Maria Boylan, Fernando Augusto Bozza, Axelle Braconnier, Cynthia Braga, Filipa Brás Monteiro, Luca Brazzi, Dorothy Breen, Kathy Brickell, Shaunagh Browne, Marjolein Brusse-Keizer, Petra Bryda, Nina Buchtele, Polina Bugaeva, Marielle Buisson, Erlina Burhan, Aidan Burrell, Ingrid G. Bustos, Denis Butnaru, André Cabie, Eder Caceres, Cyril Cadoz, Rui Caetano Garcês, Jose Andres Calvache, João Camões, Valentine Campana, Paul Campbell, Cecilia Canepa, Pauline Caraux-Paz, Chiara Simona Cardellino, Filipa Cardoso, Filipe Cardoso, Nelson Cardoso, Sofia Cardoso, Nicolas Carlier, Thierry Carmoi, Gayle Carney, Inês Carqueja, Marie-Christine Carret, François Martin Carrier, Gail Carson, Maire-Laure Casanova, Mariana Cascão, Siobhan Casey, José Casimiro, Bailey Cassandra, Silvia Castañeda, Nidyanara Castanheira, Guylaine Castor-Alexandre, Ivo Castro, François-Xavier Catherine, Paolo Cattaneo, Roberta Cavalin, Alexandros Cavayas, Minerva Cervantes-Gonzalez, Anissa Chair, Catherine Chakveatze, Adrienne Chan, Meera Cha
- Anno di pubblicazione: 2023
- Tipologia: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/625097
Abstract
Background: Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.MethodsWe included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component & GE;3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).ResultsOf 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).ConclusionsLiver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes.