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Intern Emerg Med . Impact of COVID-19 on Liver Function: Results From an Internal Medicine Unit in Northern Italy

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  • Intern Emerg Med . Impact of COVID-19 on Liver Function: Results From an Internal Medicine Unit in Northern Italy


    Intern Emerg Med


    . 2020 Jul 10.
    doi: 10.1007/s11739-020-02425-w. Online ahead of print.
    Impact of COVID-19 on Liver Function: Results From an Internal Medicine Unit in Northern Italy


    Marco Vincenzo Lenti 1 , Federica Borrelli de Andreis 1 , Ivan Pellegrino 1 , Catherine Klersy 2 , Stefania Merli 1 , Emanuela Miceli 1 , Nicola Aronico 1 , Caterina Mengoli 1 , Michele Di Stefano 1 , Sara Cococcia 1 , Giovanni Santacroce 1 , Simone Soriano 1 , Federica Melazzini 1 , Mariangela Delliponti 1 , Fausto Baldanti 3 , Antonio Triarico 4 , Gino Roberto Corazza 1 , Massimo Pinzani 5 , Antonio Di Sabatino 6 7 , Internal Medicine Covid-19 Team



    Collaborators, Affiliations

    Abstract

    Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25-97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07-5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.

    Keywords: Acute respiratory failure; Coronavirus; Hepatitis; Severe acute respiratory syndrome.

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