Title
Prospective Latin American cohort evaluating outcomes of patients with COVID-19 and abnormal liver tests on admission
Date Issued
01 March 2021
Access level
open access
Resource Type
journal article
Author(s)
Mendizabal M.
Piñero F.
Ridruejo E.
Anders M.
Silveyra M.D.
Torre A.
Montes P.
Urzúa A.
Pages J.
Toro L.G.
Díaz J.
Gonzalez Ballerga E.
Miranda-Zazueta G.
Peralta M.
Gutiérrez I.
Michelato D.
Venturelli M.G.
Varón A.
Vera-Pozo E.
Tagle M.
García M.
Tassara A.
Brutti J.
Ruiz García S.
Bustios C.
Escajadillo N.
Macias Y.
Higuera-de la Tijera F.
Gómez A.J.
Dominguez A.
Castillo-Barradas M.
Contreras F.
Scarpin A.
Schinoni M.I.
Toledo C.
Girala M.
Mainardi V.
Sanchez A.
Bessone F.
Rubinstein F.
Silva M.O.
Publisher(s)
Elsevier B.V.
Abstract
Introduction & objectives: The independent effect of liver biochemistries as a prognostic factor in patients with COVID-19 has not been completely addressed. We aimed to evaluate the prognostic value of abnormal liver tests on admission of hospitalized patients with COVID-19. Materials & methods: We performed a prospective cohort study including 1611 hospitalized patients with confirmed SARS-CoV-2 infection from April 15, 2020 through July 31, 2020 in 38 different Hospitals from 11 Latin American countries. We registered clinical and laboratory parameters, including liver function tests, on admission and during hospitalization. All patients were followed until discharge or death. We fit multivariable logistic regression models, further post-estimation effect through margins and inverse probability weighting. Results: Overall, 57.8% of the patients were male with a mean age of 52.3 years, 8.5% had chronic liver disease and 3.4% had cirrhosis. Abnormal liver tests on admission were present on 45.2% (CI 42.7–47.7) of the cohort (n = 726). Overall, 15.1% (CI 13.4–16.9) of patients died (n = 244). Patients with abnormal liver tests on admission presented higher mortality 18.7% (CI 15.9–21.7), compared to those with normal liver biochemistries 12.2% (CI 10.1–14.6); P <.0001). After excluding patients with history of chronic liver disease, abnormal liver tests on admission were independently associated with death [OR 1.5 (CI 1.1–2.0); P = 0.01], and severe COVID-19 (2.6 [2.0–3.3], P <.0001), both adjusted by age, gender, diabetes, pneumonia and body mass index >30. Conclusions: The presence of abnormal liver tests on admission is independently associated with mortality and severe COVID-19 in hospitalized patients with COVID-19 infection and may be used as surrogate marker of inflammation. Clinicaltrials.gov: NCT04358380.
Volume
21
Language
English
OCDE Knowledge area
Gastroenterología, Hepatología
Epidemiología
Subjects
Scopus EID
2-s2.0-85098942708
PubMed ID
Source
Annals of Hepatology
ISSN of the container
16652681
Sponsor(s)
We would like to thank ALEH's executive office for their invaluable help and support on this project, especially to Macarena Muñoz, María Jesús Marcone and Verónica García Huidobro. Other authors who collaborated with the data Acquisition: Máximo Cattáneoh,Jonathan Aguirre Valadezi, Germán Rojask, Edgar Ortiz-Brizuela11, Damián Conte (Hospital Privado de Córdoba, Argentina), Natalia Ratusnú (Hospital de Ushuaia, Argentina), Leyla Nazal (Clínica Las Condes, Chile), Diana Escobar (Fundación Valle de Lili, Colombia), Sarai Gonzalez Huezo (Centro Médico Issemym, Mexico).
Sources of information:
Directorio de Producción Científica
Scopus