BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) leads to elevated liver biochemistries in approximately half of patients on presentation. To date, data are limited regarding the trend of liver biochemistries over the course of illness. We aimed to evaluate the trend, etiology, and outcomes associated with liver biochemistries in COVID-19. APPROACH AND RESULTS: A total of 60 patients with COVID-19 were admitted between March 21 and March 28, 2020. The mean age was 57 years, 65% were male, and 28% were Hispanic. At the study conclusion, 6 patients were deceased, 28 were discharged, and 26 remained admitted. Patients who remained admitted were followed for a median of 12 days. Of 60 patients, 41 (69%) had at least one abnormal liver biochemistry on admission. Median aspartate aminotransferase (AST) was higher than alanine aminotransferase (ALT) at admission (46 vs. 30 U/L) and during the hospital course. Aminotransferases rose above normal in 54 (93%) patients, whereas alkaline phosphatase and total bilirubin elevations were rare. Ten (17%) patients developed aminotransferases more than 5 times the upper limit of normal. AST highly correlated with ALT throughout the illness course (r = 0.97; P < 0.0001), whereas correlations with markers of muscle injury and inflammation were weak. Statin use was common before (40%) and during admission (80%) at our center, with no difference in peak liver biochemistries between users and nonusers. No demographic or comorbid illness was associated with liver injury. Admission AST (69 vs. 49; P < 0.05), peak AST (364 vs. 77; P = 0.003), and peak ALT (220 vs. 52; P = 0.002) were higher in intubated patients. CONCLUSIONS: AST-dominant aminotransferase elevation is common in COVID-19, mirrors disease severity, and appears to reflect true hepatic injury.
BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) leads to elevated liver biochemistries in approximately half of patients on presentation. To date, data are limited regarding the trend of liver biochemistries over the course of illness. We aimed to evaluate the trend, etiology, and outcomes associated with liver biochemistries in COVID-19. APPROACH AND RESULTS: A total of 60 patients with COVID-19 were admitted between March 21 and March 28, 2020. The mean age was 57 years, 65% were male, and 28% were Hispanic. At the study conclusion, 6 patients were deceased, 28 were discharged, and 26 remained admitted. Patients who remained admitted were followed for a median of 12 days. Of 60 patients, 41 (69%) had at least one abnormal liver biochemistry on admission. Median aspartate aminotransferase (AST) was higher than alanine aminotransferase (ALT) at admission (46 vs. 30 U/L) and during the hospital course. Aminotransferases rose above normal in 54 (93%) patients, whereas alkaline phosphatase and total bilirubin elevations were rare. Ten (17%) patients developed aminotransferases more than 5 times the upper limit of normal. AST highly correlated with ALT throughout the illness course (r = 0.97; P < 0.0001), whereas correlations with markers of muscle injury and inflammation were weak. Statin use was common before (40%) and during admission (80%) at our center, with no difference in peak liver biochemistries between users and nonusers. No demographic or comorbid illness was associated with liver injury. Admission AST (69 vs. 49; P < 0.05), peak AST (364 vs. 77; P = 0.003), and peak ALT (220 vs. 52; P = 0.002) were higher in intubated patients. CONCLUSIONS:AST-dominant aminotransferase elevation is common in COVID-19, mirrors disease severity, and appears to reflect true hepatic injury.
Authors: Tingyan Wang; David A Smith; Cori Campbell; Eleanor Barnes; Philippa C Matthews; Steve Harris; Hizni Salih; Kinga A Várnai; Kerrie Woods; Theresa Noble; Oliver Freeman; Zuzana Moysova; Thomas Marjot; Gwilym J Webb; Jim Davies Journal: Hepatol Commun Date: 2021-07-10
Authors: 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 Journal: Therap Adv Gastroenterol Date: 2021-05-30 Impact factor: 4.409
Authors: Mario Romero-Cristóbal; Ana Clemente-Sánchez; Patricia Piñeiro; Jamil Cedeño; Laura Rayón; Julia Del Río; Clara Ramos; Diego-Andrés Hernández; Miguel Cova; Aranzazu Caballero; Ignacio Garutti; Pablo García-Olivares; Javier Hortal; Jose-Eugenio Guerrero; Rita García; Rafael Bañares; Diego Rincón Journal: Therap Adv Gastroenterol Date: 2021-06-14 Impact factor: 4.409