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Article ; Online: Liver function test abnormalities at hospital admission are associated with severe course of SARS-CoV-2 infection: a prospective cohort study.

Weber, Sabine / Hellmuth, Johannes C / Scherer, Clemens / Muenchhoff, Maximilian / Mayerle, Julia / Gerbes, Alexander L

Gut

2021  Volume 70, Issue 10, Page(s) 1925–1932

Abstract: ... GGT and albumin, are associated with a severe course of SARS-CoV-2 infection. ... of liver injury related to SARS-CoV-2 infection remains unclear with a need for prospective studies ... on the impact of liver function test (LFT) abnormalities at baseline.: Design: Data of 217 patients ...

Abstract Objective: Liver injury has frequently been reported in COVID-19 patients. The clinical relevance of liver injury related to SARS-CoV-2 infection remains unclear with a need for prospective studies on the impact of liver function test (LFT) abnormalities at baseline.
Design: Data of 217 patients without pre-existing liver disease prospectively included in the COVID-19 registry of the LMU university hospital were analysed in order to assess the association of abnormal LFT at admission and course of the disease. Severe course was defined as admission to the intensive care unit (ICU) or as COVID-19-related death.
Results: Abnormal LFT at baseline was present in 58% of patients, with a predominant elevation of aspartate aminotransferase (AST) (42%), gamma-glutamyltransferase (GGT) (37%) and alanine aminotransferase (ALT) (27%), hypoalbuminaemia was observed in 33%. Elevation of ALT and GGT, as well as hypoalbuminaemia, was associated with higher proportions of patients requiring ICU treatment and mechanical ventilation. After adjusting for age, gender and comorbidities, hypoalbuminaemia combined with abnormal AST or GGT at hospital admission was a highly significant independent risk factor for ICU admission (OR 46.22 and 38.8, respectively) and for a composite endpoint of ICU admission and/or COVID-19-related death (OR 42.0 and 26.9, respectively).
Conclusion: Abnormal LFTs at hospital admission, in particular GGT and albumin, are associated with a severe course of SARS-CoV-2 infection.
MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Biomarkers/blood ; COVID-19/complications ; Female ; Hospitalization ; Humans ; Liver Diseases/virology ; Liver Function Tests ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; gamma-Glutamyltransferase/blood
Chemical Substances Biomarkers ; gamma-Glutamyltransferase (EC 2.3.2.2) ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2)
Language English
Publishing date 2021-01-29
Publishing country England
Document type Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID 80128-8
ISSN 1468-3288 ; 0017-5749
ISSN (online) 1468-3288
ISSN 0017-5749
DOI 10.1136/gutjnl-2020-323800
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