학술논문
The role of liver steatosis as measured with transient elastography and transaminases on hard clinical outcomes in patients with COVID-19
Document Type
article
Author
Isabel Campos-Varela; Ares Villagrasa; Macarena Simon-Talero; Mar Riveiro-Barciela; Meritxell Ventura-Cots; Lara Aguilera-Castro; Patricia Alvarez-Lopez; Emilie A Nordahl; Adrian Anton; Juan Bañares; Claudia Barber; Ana Barreira-Diaz; Betina Biagetti; Laura Camps-Relats; Andrea Ciudin; Raul Cocera; Cristina Dopazo; Andrea Fernandez; Cesar Jimenez; Maria M Jimenez; Mariona Jofra; Clara Gil; Concepción Gomez-Gavara; Danila Guanozzi; Jorge A Guevara; Beatriz Lobo; Carolina Malagelada; Joan Martinez-Camprecios; Luis Mayorga; Enric Miret; Elizabeth Pando; Ana Pérez-Lopez; Marc Pigrau; Alba Prio; Jesus M Rivera-Esteban; Alba Romero; Stephanie Tasayco; Judit Vidal-Gonzalez; Laura Vidal; Beatriz Minguez; Salvador Augustin; Joan Genesca
Source
Therapeutic Advances in Gastroenterology, Vol 14 (2021)
Subject
Language
English
ISSN
1756-2848
17562848
17562848
Abstract
Liver injury has been widely described in patients with Coronavirus disease 2019 (COVID-19). We aimed to study the effect of liver biochemistry alterations, previous liver disease, and the value of liver elastography on hard clinical outcomes in COVID-19 patients. We conducted a single-center prospective observational study in 370 consecutive patients admitted for polymerase chain reaction (PCR)-confirmed COVID-19 pneumonia. Clinical and laboratory data were collected at baseline and liver parameters and clinical events recorded during follow-up. Transient elastography [with Controlled Attenuation Parameter (CAP) measurements] was performed at admission in 98 patients. All patients were followed up until day 28 or death. The two main outcomes of the study were 28-day mortality and the occurrence of the composite endpoint intensive care unit (ICU) admission and/or death. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were elevated at admission in 130 patients (35%) and 167 (45%) patients, respectively. Overall, 14.6% of patients presented the composite endpoint ICU and/or death. Neither ALT elevations, prior liver disease, liver stiffness nor liver steatosis (assessed with CAP) had any effect on outcomes. However, patients with abnormal baseline AST had a higher occurrence of the composite ICU/death (21% versus 9.5%, p = 0.002). Patients ⩾65 years and with an AST level > 50 U/ml at admission had a significantly higher risk of ICU and/or death than those with AST ⩽ 50 U/ml (50% versus 13.3%, p